Revisiting open capsuloplasty for the treatment of anterior shoulder instability: 35-year follow-up of the Du Toit procedure

The Du Toit open capsuloplasty for the treatment of anterior shoulder instability is based on the concept of restoring joint stability by recreating the integrity of the anterior glenoid labrum and inferior gleno-humeral ligament using staples. The long-term validity of this procedure for the treatment of anterior shoulder instability was retrospectively assessed by a clinical or telephone interview and radiographic evaluation in 58 patients with an average 35-year follow-up between 1948 and 1974. The range of motion was evaluated by comparing the treated side with the contralateral one; subjective and objective evaluation was performed according to the ASES, Rowe scales and Constant rating system; A-P and axillary X-rays were performed to evaluate glenohumeral arthrosis by the Samilson criteria. Despite the need for a second operation due to staple loosening (5 of 58 patients in our series), this open procedure for shoulder instability gave a high rate of satisfactory results, thus holding the ground for the current concept of the modern arthroscopic Bankart repair.